The national disaster medical system past, present, and suggestions for the future

Crystal Franco, Eric Toner, Richard Waldhorn, Thomas V. Inglesby, Tara O'Toole

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


This article reviews the history and structure of the National Disaster Medical System (NDMS), with an emphasis on its definitive care component. NDMS's capacity to handle very large mass casualty events, such as those included in the National Planning Scenarios, is examined. Following Hurricane Katrina, Congress called for a reevaluation of NDMS. In that context, we make three key suggestions to improve NDMS's capacity to respond to large mass casualty disasters: (1) increase the level of engagement by the private (i.e., nonfederal) healthcare system in preparedness and response efforts; (2) increase the reliance on regional hospital collaborative networks as part of the backbone of the NDMS system; and (3) develop additional, alternative patient transportation systems, linked to the overall NDMS patient tracking effort, to decrease the sole reliance on DoD long-haul air transport in medical evacuation.

Original languageEnglish (US)
Pages (from-to)319-326
Number of pages8
JournalBiosecurity and Bioterrorism
Issue number4
StatePublished - Dec 1 2007
Externally publishedYes

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Management, Monitoring, Policy and Law


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